Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2014:2014:414125.
doi: 10.1155/2014/414125. Epub 2014 Jul 17.

Haematuria: an imaging guide

Fiachra Moloney  1 , Kevin P Murphy  1 , Maria Twomey  1 , Owen J O'Connor  1 , Michael M Maher  1
Affiliations
Review

Haematuria: an imaging guide

Fiachra Moloney et al. Adv Urol. 2014.

Abstract

This paper discusses the current status of imaging in the investigation of patients with haematuria. The physician must rationalize imaging so that serious causes such as malignancy are promptly diagnosed while at the same time not exposing patients to unnecessary investigations. There is currently no universal agreement about the optimal imaging work up of haematuria. The choice of modality to image the urinary tract will depend on individual patient factors such as age, the presence of risk factors for malignancy, renal function, a history of calculus disease and pregnancy, and other factors, such as local policy and practice, cost effectiveness and availability of resources. The role of all modalities, including conventional radiography, intravenous urography/excretory urography, ultrasonography, retrograde pyelography, multidetector computed tomography urography (MDCTU), and magnetic resonance urography, is discussed. This paper highlights the pivotal role of MDCTU in the imaging of the patient with haematuria and discusses issues specific to this modality including protocol design, imaging of the urothelium, and radiation dose. Examination protocols should be tailored to the patient while all the while optimizing radiation dose.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Intravenous urogram (bladder image obtained 15 minutes following contrast administration). There is an infiltrative mass lesion involving the bladder wall on the right. This was confirmed to be a urothelial cell carcinoma following biopsy at cystoscopy.
Figure 2
Figure 2
Intravenous urogram demonstrates a filling defect in the lower pole calyx of the left kidney, a histologically-proven urothelial cell carcinoma.
Figure 3
Figure 3
Renal ultrasound demonstrates an exophytic hypoechoic solid mass arising from the lower pole of the kidney consistent with a renal cell carcinoma.
Figure 4
Figure 4
Retrograde pyelogram. There is an irregular infiltrative mass involving the renal pelvis and proximal ureter. This was a histologically proven urothelial cell carcinoma.
Figure 5
Figure 5
CT urogram (coronal urographic phase image) demonstrates a large polypoid mass arising from the bladder wall. This was confirmed to be a urothelial cell carcinoma following biopsy at cystoscopy.
Figure 6
Figure 6
CT of kidneys (coronal nephrographic phase image) demonstrates an enhancing mass lesion arising from the lower pole of the left kidney consistent with a histologically confirmed renal cell carcinoma.
Figure 7
Figure 7
CT urogram (coronal urographic phase image) demonstrates a filling defect in the upper moiety of a duplex right kidney. This was histologically confirmed to be urothelial cell carcinoma following ureteroscopy and biopsy.
Figure 8
Figure 8
T2-weighted MR urography demonstrates a mass at the upper pole of the left kidney directly invading the renal pelvis.
Figure 9
Figure 9
Coronal T2-weighted MRI of kidneys shows a large heterogeneous low T2 signal mass centered in the upper pole of the left kidney.
See this image and copyright information in PMC

References

    1. European Association of Urology guidelines. Proceedings of the 25th EAU Annual Congress; 2010; Barcelona, Spain.
    1. Davis R, Jones JS, Barocas DA, et al. Diagnosis, evaluation and follow-up of asymptomatic microhematuria (AMH) in adults: AUA guideline. Journal of Urology. 2012;188(6):2473–2481. - PubMed
    1. Patel D, Patel U. Role of radiological imaging for the evaluation of hematuria. Trends in Urology & Men's Health. 2011;2(6):15–19.
    1. O'Connor OJ, Fitzgerald E, Maher MM. Imaging of hematuria. American Journal of Roentgenology. 2010;195(4):W263–W267. - PubMed
    1. O’Connor OJ, McSweeney SE, Maher MM. Imaging of Hematuria. Radiologic Clinics of North America. 2008;46(1):113–132. - PubMed

LinkOut - more resources